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<body>
    <div class="success_content success_good">
        <div class="form_box">
            <form action="">
                <div class="div_box">
                    <div class="label">
                        姓名
                    </div>
                    <div class="inp">
                        <input type="text" placeholder="请输入姓名">
                    </div>
                </div>
                <div class="div_box">
                    <div class="label">
                        手机号码
                    </div>
                    <div class="inp">
                        <input type="text" placeholder="请输入手机号码">
                    </div>
                </div>
                <div class="div_box">
                    <div class="label">
                        邮寄地址
                    </div>
                    <div class="inp">
                        <textarea name="" id="" placeholder="请输入详细地址：如道路、门牌号、小区、楼栋号、单元室等"></textarea>
                    </div>
                </div>
                <div class="div_box">
                    <div class="label">
                        所获奖品名称
                    </div>
                    <div class="inp">
                        <input type="text" placeholder="请输入奖品名称">
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            </form>
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        <div class="tips_box">
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                填写说明：
            </div>
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                1.手机号应与“恭喜中奖”页面中所填手机号一致，方便联系本人接收奖品。
            </div>
            <div class="tips_msg">
                2.我方工作人员一般会在7个工作日内与中奖客户电话联系确认并邮寄奖品，联系日起连续3个工作日内无法与中奖用户取得联系，视为用户自动放弃中奖资格。
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                3.如有疑问，可致电4008070025进行客服咨询。
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